Subcortical Ischemic Vascular Dementia
Section snippets
Conceptualization: history, frontal-subcortical loops, diagnostic criteria
The wide range of cerebrovascular disease (CVD) and its associated clinical phenotypes have inspired many classification schemes. CVD is divided into large versus small artery disease. Stroke is divided into ischemic versus hemorrhagic subtypes. Multi-infarct dementia (MID) was split into cortical versus subcortical dementia. This article focuses on a proposed subtype known as subcortical vascular dementia (SVD) or SIVD, which is characterized by lacunar infarctions and deep white matter
Brain-behavior correlations: imaging-clinical-pathologic data
The versatility and power of MRI offer exciting clinical and research opportunities. High-field MRI at 3 or more tesla offers unprecedented anatomic resolution, functional MRI and perfusion MRI give excellent temporal resolution, and diffusion tensor imaging provides information about architectural integrity. This review focuses on new findings using structural MRI (ie, T1-weighted, T2-weighted, and proton density sequences).
When studies are designed to address specific hypotheses, a
Epidemiologic evidence
Many factors, such as age, hypertension, diabetes mellitus, smoking, high cholesterol, and heart disease, are risk factors for stroke, regardless of subtype (Fig. 12) [51]. In a recent meta-analysis of 16 studies, hypertension and diabetes seemed somewhat more common with lacunar versus nonlacunar or cardioembolic stroke, but this may be confounded by the circular inclusion of risk factor profiles in the definition of stroke subtype [52]. In the Atherosclerosis Risk in Communities study, the
Summary
Epidemiologic data suggest that prevention of SIVD is akin to prevention of stroke. Identification and treatment of vascular risk factors, such as hypertension, diabetes mellitus, and hyperlipidemia, is a high priority [71]. Overall, antihypertensive therapy is associated with a 35% to 44% reduction in the incidence of stroke. Only 70% of Americans who have hypertension are aware of their condition, 60% are under treatment, and 34% are controlled successfully [72]. Lack of diagnosis and
References (72)
- et al.
The neuropsychology of paramedian thalamic infarction
Brain Cogn
(1988) - et al.
Parallel organization of functionally segregated circuits linking basal ganglia and cortex
Annu Rev Neurosci
(1990) - et al.
Prevention of dementia in randomized double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial
Lancet
(1998) - et al.
Efficacy of galantamine in probable vascular dementia and Alzheimer's disease combined with cerebrovascular disease: a randomized trial
The Lancet
(2002) Des foyers lacunaires de desintegration et de differents autres etats cavitaires du cerveau
Rev Med
(1901)Essai sur l'hemiplegie des vieillards: les lacunes de desintegration cerebrale
Paris These
(1902)Lacune: small deep cerebral infarcts
Neurology (Minneap)
(1965)- et al.
Why do frontal lobe symptoms predominante in vascular dementia with lacunes?
Neurology
(1986) - et al.
An autopsy study of the incidence of lacunes in relation to age, hypertension, and arteriosclerosis
Stroke
(1991) - et al.
Thalamic infarcts: clinical syndrome, etiology and prognosis
Neurology
(1988)
Dementia following strokes in the mesencephalon and diencephalon
Arch Neurol
Die Abgrenzung der allgemeinen progressiven Paralyse
Berl Klin Wochenschr
Die Seelenstorungen auf arteriscleroticsher Grundlage
Allgem Z Psychiatr Psych Gerichtl Med
Binswanger chronic progressive subcortical encephalopathy
Neurology
Senile dementia of the Binswanger type. A vascular form of dementia in the elderly
JAMA
The significance of cerebral white matter abnormalities 100 years after Binswanger's report: a review
Stroke
Characterization of risk factors for vascular dementia. The Honolulu Asia Aging Study
Neurology
Cranial computed tomographic observations in multi-infarct dementia: a controlled study
Stroke
Frontal-subcortical circuits and human behavior
Arch Neurol
Fiber pathways of the brain
Association, commissural, and projection pathways and their functional deficit reported in the literature
J Comput Assist Tomogr
The human periventricular arterial blood supply and the anatomy of cerebral infarctions
Eur Neurol
Features of the cerebral vascular pattern that predict vulnerability to perfusion or oxygenation deficiency: an anatomic study
Am J Neurorad
Neurobehavioral changes associated with caudate lesions
Neurology
Confusion and memory loss from capsular genu infarction: a thalamocortical disconnection syndrome?
Neurology
Nonhaemorrhagic thalamic infarction
Brain
The thalamus and behavior: effects of anatomically distinct strokes
Neurology
White matter lesions impair frontal lobe function regardless of their location
Neurology
Cognitive consequences of thalamic, basal ganglia, and deep white matter lacunes in brain aging and dementia
Stroke
Research criteria for subcortical vascular dementia in clinical trials
J Neural Transm
User's guide to the medical literature. III. How to use an article about a diagnostic test. A. What are the results and will they help me in caring for my patients?
JAMA
Cognitive impact of subcortical vascular and Alzheimer disease pathology
Ann Neurol
Profiles of neuropsychological impairment in autopsy-defined Alzheimer's disease and cerebrovascular disease
Neurology
National Institute of Neurological Disorders and Stroke–Canadian stroke network vascular cognitive impairment harmonization standards
Stroke
Clinical correlates of white matter findings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study
Stroke
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This work was supported by NIH Grant P01 AG12435 “The Aging Brain: Vasculature, Ischemia, Behavior” and the State of California Department of Health Services.